Research on the rape trauma syndrome (RTS) continues to be atheoretical, plagued with methodological flaws, and to yield conflicting and indeterminant findings. The proposed research will study the short and medium-term effects of sexual assault on psychological and physical well-being with an emphasis on the role of life stresses, coping, and social support as they influence trauma and are in turn affected by the adjustment process. The long-term objective of the research is to provide the valid and reliable empirical data on adjustment to RTS necessary to improve our understanding of crisis adjustment, redesign interventions, and assist program evaluation. Specific aims include: developing several alternative theoretical models of RTS and testing hypotheses about the interaction of previous experiences and life situation of the victim, including prior stress, coping, social support and social-demographic characteristics, with the nature of the sexual assault, initial trauma reaction, and subsequent change in stress, coping and support. Finally, we will implement an improved design over earlier research emphasizing a longitudinal multivariate analysis of adjustment to RTS. This prospective panel study plans to utilize redesigned clinical data collected by the Sex Abuse Treatment Center, Kapiolani-Children's Medical Center, Honolulu, Hawaii, on 540 adult female sexual assault victims. These clinical data will be supplemented with systematic interviews by project staff over a two-year period. Interviews will assess trauma (type and level) at intake within hours of assault and change in trauma over time (at 2 weeks, 3, 6, 12, and 24 months) using multiple measures of psychological distress, social role performance, life-event stress, coping and social support. The longitudinal multivariate statistical analysis will be undertaken primarily with multiple regression using SPSSx and will include consideration of non-linear, non-additive, and indirect effects of the specification variables in the context of model tests using LISREL.